Suboxone (buprenorphine/naloxone) is a prescription drug that’s used to treat opioid use disorder. Suboxone comes as a film that dissolves in your mouth. It’s usually taken once per day.
Suboxone is prescribed for adults to treat opioid use disorder.
Suboxone is a combination drug. It contains the active ingredients buprenorphine and naloxone. (An active ingredient is what makes a drug work.)
Buprenorphine is a partial opioid agonist. It produces mild opioid effects while blocking stronger opioids from attaching to receptors. Naloxone is an opioid antagonist. It blocks opioids from attaching to receptors.
Suboxone comes as a film that dissolves under your tongue or between your cheek and gums.
This article describes the dosages of Suboxone, as well as its strengths and how to take it. To learn more about Suboxone, see this in-depth article.
The second phase of treatment is called the maintenance phase. You’ll be on a stable dosage of Suboxone during the maintenance phase. You’ll continue to meet with your doctor at least once per week during the first month of treatment.
What is the form of Suboxone?
Suboxone comes as a film that dissolves under your tongue (sublingual) or between your cheek and gums (buccal).
What strengths does Suboxone come in?
Suboxone comes in four strengths:
- 2 milligrams (mg) buprenorphine/0.5 mg naloxone
- 4 mg buprenorphine/1 mg naloxone
- 8 mg buprenorphine/2 mg naloxone
- 12 mg buprenorphine/3 mg naloxone
What are the usual dosages of Suboxone?
The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.
Dosage for opioid dependence
Suboxone is used to manage withdrawal symptoms during the induction phase for short-acting opioids only.* Short-acting opioids include heroin, codeine, oxycodone (Oxycontin, Roxicodone), and morphine (MS Contin). During the induction phase, Suboxone should be dissolved under the tongue.
On the first day, your doctor will start your treatment with one of the following strengths of Suboxone: 2 mg buprenorphine/0.5 mg naloxone or 4 mg buprenorphine/1 mg naloxone.
You’ll be observed for several hours. Additional doses may be given to treat withdrawal symptoms. The maximum dosage of Suboxone for the first day is 8 mg buprenorphine/2 mg naloxone.
On the second day, your doctor may give you the total dose of Suboxone you received on the first day. But if you’ve had significant withdrawal symptoms, your doctor may increase this dose by 2 mg buprenorphine/0.5 mg naloxone or 4 mg buprenorphine/1 mg naloxone.
Again, you’ll be observed for several hours, and additional doses may be given.
This process may go on for additional days until your withdrawal symptoms are well-controlled and the correct dose of Suboxone for you has been determined. You’ll then continue on this dose once per day as your maintenance dosage. Once on your maintenance dosage, you can dissolve Suboxone under your tongue or between your cheek and gums.
Typical maintenance dosages of Suboxone are between 4 mg buprenorphine/1 mg naloxone and 24 mg buprenorphine/6 mg naloxone once per day, but your dosage will depend on your response to treatment. The maximum dosage of Suboxone is 24 mg buprenorphine/6 mg naloxone per day.
*For dependence on long-acting opioids such as methadone, doctors prescribe a 2-day induction of buprenorphine alone before prescribing Suboxone as a maintenance therapy.
Is Suboxone taken long term?
Yes, if you and your doctor determine that Suboxone is safe and effective for your condition, you’ll likely take it long term.
If you’re pregnant and taking Suboxone, you should meet with your doctor regularly. During pregnancy, your doctor may need to adjust your Suboxone dosage. If you experience any withdrawal symptoms during pregnancy, tell your doctor.
Below are answers to some commonly asked questions about Suboxone’s dosage.
What do I do if my Suboxone dose is too low?
If your Suboxone dose is too low, tell your doctor right away. Signs and symptoms that your dose may be too low include:
- nausea and vomiting
- lethargy (low energy, lack of motivation)
- muscle aches
- insomnia (difficulty sleeping)
- drug cravings
Symptoms are similar but tend to be milder than typical opioid withdrawal symptoms.
If you think your Suboxone dosage is too low, do not increase your dose on your own. Talk with your doctor as soon as you can.
Can Suboxone be used for pain? If so, what’s the dosage?
Suboxone isn’t used as pain medication in people who don’t have opioid use disorder. It hasn’t been effective as pain management in this group of people.
One of Suboxone’s active ingredients, buprenorphine, can be used alone to treat severe pain that hasn’t been controlled with other pain medications. However, it has caused death when given as a pain medication to people who aren’t tolerant to opioids.
Drug manufacturers don’t provide dosage recommendations for off-label uses. But if you’d like to learn more about treating your pain with Suboxone, talk with your doctor.
Once you’re on your maintenance dosage, you’ll take Suboxone once per day.
Suboxone comes as a film that dissolves under your tongue or between your cheek and gums. It should be taken whole. Do not cut, chew, or swallow the film. Do not eat or drink anything until the film has completely dissolved. Do not move the film after it’s been placed in your mouth.
For placement under the tongue. Place one film under your tongue. If you need more than one film to complete your dose, place them both under the tongue — one on the right side and one on the left side. Try to avoid having the films overlap. Keep the film under your tongue until it has completely dissolved. If you need a third film, follow the same steps but only after the first two films have dissolved.
For placement between the cheek and gums. Place one film on the inside of the cheek, between the cheek and gums. If you need more than one film to complete your dose, place it on the inside of the opposite cheek. Keep the film in place until it has completely dissolved. If you need a third film, follow the same steps but only after the first two films have dissolved.
After the film has completely dissolved, take a sip of water and gently swish the water around your teeth and gums. Swallow the water.
Wait at least 1 hour before brushing your teeth.
For information on the expiration, storage, and disposal of Suboxone, see this article.
Accessible drug containers and labels
Some pharmacies provide medication labels that:
- have large print or use braille
- feature a code you can scan with a smartphone to change the text to audio
Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.
If you miss a dose of Suboxone, take it as soon as you remember. But if it’s almost time for your next dose, skip your missed dose and take your next dose at its regularly scheduled time. You should not take two doses of Suboxone at once. If you’re not sure if you should take a missed dose or skip it, talk with your doctor or pharmacist.
If you need help remembering to take your dose of Suboxone on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
Yes, Suboxone has the potential for misuse. With misuse, a person takes a drug in a way other than how it’s prescribed.
Suboxone contains the active ingredient buprenorphine. The federal government has classified buprenorphine and all drugs that contain buprenorphine as Schedule III drugs. This means Suboxone has moderate potential for misuse.
Your doctor will take certain precautions to minimize the risk of misuse. Initial precautions may include:
- giving you the medication under supervision
- prescribing a limited supply of Suboxone at once
- scheduling frequent follow-up appointments
- requesting urine drug screening
With time, as you make progress in your treatment, these precautions may no longer be necessary.
Do not take more Suboxone than your doctor prescribes, as this can lead to harmful effects.
Symptoms of an overdose
Symptoms caused by an opioid overdose can include:
- small pupils
- stupor (unresponsiveness to normal conversation)
- slow and ineffective breathing
- slow heart rate or weak pulse
What to do in case you take too much Suboxone
Due to the risk of opioid overdose in people being treated for opioid use disorder, your doctor may have given you a prescription for Narcan (naloxone). Companions should be educated on the signs of an opioid overdose and how to give naloxone.
In the event of an opioid overdose, a companion should immediately administer naloxone if it’s available. They should then call 911 (or the local emergency number) or bring you to the nearest emergency room.
If you abruptly stop taking Suboxone, you may experience moderate withdrawal symptoms. This is because buprenorphine, one of the active ingredients in Suboxone, has the potential for dependence. With dependence, your body needs the drug to function as usual.
Withdrawal symptoms tend to be their worst after 3 or 4 days and could last up to 2 weeks. Symptoms include:
- flu-like symptoms
- muscle aches
- running nose
- drug cravings
When you and your doctor decide to stop Suboxone, it can be done safely with a drug taper. With a drug taper, your dose is slowly decreased over several weeks. This helps decrease withdrawal symptoms and increases your chance of successfully stopping Suboxone.
The sections above describe the usual dosages provided by the drug’s manufacturer. If your doctor recommends Suboxone for you, they’ll prescribe the dosage that’s right for you.
Remember, you should not change your dosage of Suboxone without your doctor’s recommendation. Only take Suboxone exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.
Here are some examples of questions you may want to ask your doctor:
- How do I know if my Suboxone dosage is right for me?
- How long will I receive Suboxone in my doctor’s office?
- Does it make a difference if I place the film under my tongue or inside my cheek?
- Does my risk of dependence increase if I’m prescribed a higher dosage of Suboxone?
To learn more about Suboxone, see these articles:
- Suboxone(buprenorphine and naloxone)
- Side Effects of Suboxone: What You Need to Know
- Suboxone Interactions: Alcohol, Medications, and Others
- Sublocade vs. Suboxone: What You Should Know
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.